A study on the effective cleaning of healing abutment using healing abutment case

Abstract

Background: As with natural teeth, plaque and calculus may be deposited around the implant's healing abutment. In most dental clinic, the surface of the healing abutment is cleaned with alcohol swab while loosened. Recently developed healing abutment case (OHAC®, Osstem implant co, Seoul, Korea) has made it possible to use ultrasonic cleaners without positional displacement when multiple healing abutments are removed. Aim/Hypothesis: Purpose of study is to investigate the effectiveness of cleaning of healing abutment using healing abutment case by observing oral microorganisms using phase contrast microscope. Materials and Methods: 32 patients with two or more implants placed in a same side of jaw were included in this study. Two healing abutments were selected per each patient, so total 64 healing abutments were used. In control group, healing abutments were cleaned with alcohol swab only. In experimental group, healing abutments were put in healing abutment case and cleaned with an ultrasonic cleaners filled with 0.05% chlorhexidine solution for 5 minutes after cleaned with alcohol swab. 0.5 ml of physiological saline was separated from the sterilized slide glass and then covered with a cover glass and the shape and amount of the microorganisms were observed with phase contrast microscope. The number of microorganism displayed on the screen was counted and classified into 0 to 3 degree according to the amount of each microorganism. Results: No significant difference in the amount of oral microorganism was found between experimental and control groups at first visit. There was no significant difference in the amount of oral microorganism according to gender, maxilla or mandible, buccal or lingual surface. In comparison between supra-gingival and sub-gingival area, supra-gingival area contains significantly higher amounts of oral microorganism than that of sub-gingival area (P < 0.05). In comparison between before and after cleaning of experiment at first visit, significantly less amount of microorganism was found after cleaning (P < 0.05). The most commonly observed oral microorganism was Cocci, with statistically significant differences when compared with other species (P < 0.05), while no significant difference was found between Bacilli, Filamentous, Comma/Spiral. In comparison between groups at second visit, it was found that experimental group had significantly less amount of oral microorganism than control group (P < 0.05). Conclusions and Clinical Implications: Cleaning with healing abutment case in 0.05% chlorhexidine solution is more effective than alcohol swab. As more microorganisms were found in supra-gingival area than sub-gingival, exposed intra-oral site should be well cleaned. Method of experimental group was found to have surface polishing effect which may affect reduction of bacterial adhesion at second visit. Education will be needed to make patient recognize importance of cleaning around healing abutment and to manage by brushing teeth. Keywords: Healing Abutment, Healing Abutment Case, Cleaning Healing Abutment with Healing Abutment Case